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Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease

Karlijn F de Laat1, Anouk G W van Norden, Lucas J B van Oudheusden

  • 1Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Neurobiology of Aging
|October 18, 2011
PubMed

Insights

Mild parkinsonian signs (MPS) in elderly individuals with cerebral small vessel disease (SVD) are linked to white matter lesion (WML) integrity. Diffusion tensor imaging reveals frontal lobe WMLs are key indicators of MPS risk.

Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Cerebral small vessel disease (SVD) is common in the elderly and linked to neurological deficits.
  • White matter lesions (WMLs) and lacunar infarcts are key markers of SVD.
  • The relationship between SVD, specifically WML microstructural integrity, and mild parkinsonian signs (MPS) requires further investigation.

Purpose of the Study:

  • To investigate the association between microstructural integrity of WMLs, normal-appearing white matter (NAWM), and MPS in elderly subjects with SVD.
  • To determine if the location of white matter damage influences the presence of MPS.
  • To explore the utility of diffusion tensor imaging (DTI) in understanding MPS mechanisms in SVD.

Main Methods:

  • Diffusion tensor imaging (DTI) was used to assess white matter integrity.
  • 483 elderly subjects with SVD but without parkinsonism were examined.
  • Fractional anisotropy (FA) was measured in WMLs, NAWM, and specific regions of interest (ROIs), particularly the periventricular frontal regions.

Main Results:

  • Severe loss of integrity within WMLs was associated with a higher risk of MPS (OR=1.9, 95% CI 1.1-3.4), independent of WML volume.
  • While NAWM integrity showed an initial association with MPS, it disappeared after adjusting for WMLs and lacunar infarcts.
  • Reduced integrity in periventricular frontal ROIs was significantly linked to MPS, independent of WMLs and lacunar infarcts.

Conclusions:

  • The microstructural integrity of WMLs, particularly in the frontal lobe, is associated with mild parkinsonian signs in individuals with SVD.
  • DTI is a valuable tool for investigating the underlying mechanisms of parkinsonian signs in the context of SVD.
  • Frontal lobe white matter integrity may play a crucial role in the development of MPS in SVD patients.

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